who should you report breaches of confidentiality to someone who can advocare for the patient

by Ronaldo Block 6 min read

Breach of Confidentiality - Standards of Care

35 hours ago  · Johnson says to report the breach of patient confidentiality up the chain of command. It's usually appropriate for nurses to report to nurse supervisors or managers; they might also make a report to a department head. >> Go To The Portal


Patient confidentiality is not absolute. Legitimate exceptions are disclosures with patient consent, when required by law and where there is a public interest. When breaching patient confidentiality and patient consent cannot be obtained, seek advice from senior colleagues or a medical defence union and document your reasons clearly.

Full Answer

When can confidentiality of a patient be breached?

Such situations may arise, for example, if a patient threatens to harm others; if they have a serious communicable disease; or if they are continuing to work or drive when they are not fit to do so. The confidentiality of a patient should only be breached in exceptional circumstances and in line with GMC guidance.

Why are some of the confidentiality breaches reported by observers excluded?

Five of the confidentiality breaches reported by the observers were excluded from the study because some of the situations involved incidents not directly related to confidentiality.

Can you sue a doctor for breach of confidentiality?

If a doctor breaches the confidential relationship by disclosing protected information, the patient may be entitled to bring a lawsuit against the doctor. The patient may be able to recover compensatory damages, including emotional suffering and damage to reputation resulting from the disclosure.

Who is responsible for patient confidentiality under HIPAA?

Patient Rights and Breaches of Confidentiality According to HIPAA, medical professionals and other workers in healthcare and medical records are responsible for protecting and maintaining patient information, both to ensure that patients get continuity in coverage and care and also to protect patient privacy.

How would you handle a breach of patient confidentiality?

Take immediate action to stop the breach if applicable For example, if a coworker is discussing a patient with you and you don't have a professional reason to know about the case, remind them that patient confidentiality laws are in play and they should stop discussing the patient with you.

Who responsibility is it to maintain patient confidentiality?

Confidentiality is one of the core duties of medical practice. It requires health care providers to keep a patient's personal health information private unless consent to release the information is provided by the patient.

What happens when patient confidentiality is breached?

If a doctor breaches the confidential relationship by disclosing protected information, the patient may be entitled to bring a lawsuit against the doctor. The patient may be able to recover compensatory damages, including emotional suffering and damage to reputation resulting from the disclosure.

What happens if patient confidentiality or privacy are breached?

Patient confidentiality is protected under state law. If a patient's private information is disclosed without authorization and causes some type of harm to the patient, he or she could have a cause of action against the medical provider for malpractice, invasion of privacy, or other related torts.

What is the nurse's role in maintaining confidentiality?

The nurse has a duty to maintain confidentiality of all patient information, both personal and clinical, in the work setting and off duty in all venues, including social media or any other means of communication (p.

When can you breach confidentiality in nursing?

Breaking confidentiality is done when it is in the best interest of the patient or public, required by law or if the patient gives their consent to the disclosure. Patient consent to disclosure of personal information is not necessary when there is a requirement by law or if it is in the public interest.

What happens if confidentiality is breached in nursing?

A breach of the duty of confidence can have a number of consequences. For example, it may lead to: Disciplinary action by the employer of the person who made the disclosure. Legal action claiming damages (compensation) against the person who made the disclosure and/or his or her employer.

What happens if a nurse breaches confidentiality of a client?

Either could also cause a lawsuit against you and your facility. Your facility may not have your back and often cases against the facility are dropped citing the nurse knew what s/he was doing was wrong. Depending on the severity, you could even face suspension or loss of your license.

What happens if a patient's private information is disclosed without authorization?

If a patient's private information is disclosed without authorization and causes some type of harm to the patient, he or she could have a cause of action against the medical provider for malpractice, invasion of privacy, or other related torts. Of course, if the patient consented to the disclosure, no breach occurred.

What happens to a patient's confidentiality after he dies?

The duty of confidentiality continues even after a patient has stopped seeing or being treated by that particular doctor. The duty even survives the death of a patient. That means if the patient passes away, his or her medical records and information are still protected by doctor-patient confidentiality.

What is confidentiality in medical terms?

Because these types of relationships often involve very personal and sensitive information (such as medical conditions or personal finances), confidentiality serves to facilitate open and forthright communication between both parties -- thereby serving the best interests of all involved. This article focuses on breaches of doctor-patient confidentiality, the scope of the law, and what to do to protect yourself.

What is the duty of confidentiality?

The professional duty of confidentiality covers not only what a patient may reveal to the doctor, but also any opinions and conclusions the doctor may form after having examined or assessed the patient.

Why is confidentiality important in a relationship?

Because these types of relationships often involve very personal and sensitive information (such as medical conditions or personal finances), confidentiality serves to facilitate open and forthright communication between both parties -- thereby serving the best interests of all involved.

What is the purpose of a doctor-patient relationship?

The objective of this confidential relationship is to make patients feel comfortable enough providing any and all relevant information.

Can a doctor disclose medical information to a third party?

He or she cannot divulge any medical information about the patient to third persons without the patient's consent, though there are some exceptions (e.g. issues relating to health insurance, if confidential information is at issue in a lawsuit, or if a patient or client plans to cause immediate harm to others).

What is patient privacy?

Patient confidentiality and privacy rights are a serious matter in the eyes of the law. Access to patient information is for the people assigned to provide care, and is on a "need-to-know" basis. 1 Each state's nursing practice act and the Centers for Medicare and Medicaid Services ensure the protection of patient privacy and rights.

Is confidentiality a willful violation of policies?

Although most breaches of confidentiality aren't a willful violation of policies, the nurse in this situation didn't consider the consequences of her actions before taking the path that breached patient confidentiality. As a result of this situation, the managers collaborated to prevent this from happening again.

What are the confidentiality rules for doctors?

Doctor-patient confidentiality rules vary significantly by state. In most states, the rules apply to relationships involving physicians and psychotherapists. But the rules often do not apply to relationships involving dentists, optometrists , or pharmacists.

Why do doctors have confidentiality rules?

These rules of confidentiality exist, in part, to encourage patients to be frank with their doctors. Since medical issues can be very private, patients might avoid telling doctors certain details if the patient believes that the information could go beyond doctor's ears (or the patient's treatment chart).

What happens if a doctor discloses privileged information in court?

In court, the patient must assert the privilege. If a doctor begins to disclose privileged information in court, the patient (or his or her attorney) must object. Otherwise, the patient waives the privilege.

How does a patient waive the doctor-patient privilege?

A patient waives the privilege by initiating a lawsuit in which the patient's health is at issue, as long as the interactions between the doctor and patient are relevant to the lawsuit. So, a patient nearly always waives doctor-patient privilege by filing a medical malpractice lawsuit against a doctor.

What is the importance of confidentiality in a doctor?

Doctor-patient confidentiality protects not only words, but also observations. A doctor's observations during an examination of a patient are considered part of the communications that were made between the two individuals, and they are privileged as a result.

Can a patient recover damages from a wrongful disclosure?

The patient may be able to recover compensatory damages, including emotional suffering and damage to reputation resulting from the disclosure. In some states, courts will assume that the patient was damaged by a wrongful disclosure by a doctor (meaning that the patient will not have to actually prove damages).

Can a doctor disclose the date of an examination?

A doctor can disclose very basic facts about the examination without breaching the privilege . The doctor can indicate that the patient came in for an examination, the dates of treatment, and to whom the bill was tendered.

What happens if a therapist fails to take reasonable steps to protect the intended victim from harm?

“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.

Should clients withhold anything from their therapist?

“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.

Can a therapist report a patient's intent to harm someone else?

A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.

Do therapists have to disclose information in court?

For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.

Do you have to report child abuse to a therapist?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

Who explains the GMC's updated guidance on confidentiality?

Marika Davies explains the GMC’s updated guidance on confidentiality. Patients often confide in their doctors, and can usually do so safe in the knowledge that what they disclose will only be shared with those directly involved in their care. But occasionally a patient will tell you something that makes you concerned for the safety of others.

Who to consult if you are not sure how the law applies?

If you are not sure how the law applies, you should consult a Caldicott guardian or your medical defence organisation.

What does the GMC say about disclosure?

Making the disclosure. If it is not practicable or safe to seek consent, or if the patient refuses to give consent, and you are satisfied that information should be disclosed, the GMC says that you should act quickly. You should keep disclosures to the minimum necessary for the purpose.

Why is disclosure justified?

The GMC says that a disclosure may be justified to protect individuals or society from the risk of serious harm, such as from serious communicable diseases or serious crime . For example if the disclosure is likely to be necessary for the prevention, detection, or prosecution of crime, especially crimes against the person.

When deciding if a disclosure is necessary in the public interest, should you consider whether a failure to disclose

In deciding if a disclosure is necessary in the public interest you should consider whether a failure to disclose would expose others to a risk of death or serious harm. The GMC says that “the benefits to an individual or society of the disclosure must outweigh both the patient’s and the public interest in keeping the information confidential.”.

What age do you have to be to report a genital mutilation?

There are also a number of laws that require doctors to disclose patient information, for purposes including the notification of infectious diseases, the prevention of terrorism, and the reporting of female genital mutilation in girls under the age of 18.

Can a patient tell you something that makes you concerned for the safety of others?

But occasionally a patient will tell you something that makes you concerned for the safety of others. Deciding whether or not to breach confidentiality in these situations can be challenging for doctors, who are mindful of both the importance of trust in the doctor-patient relationship and their wider duty to protect the public.

What is the importance of patient confidentiality?

What this case underscores about patient confidentiality is that there can be liability for a facility for its own duties to protect a patient’s medical information.

What did the letter to Doe from the President and CEO of the facility informing him of?

A letter was sent to Doe from the president and CEO of the facility informing Doe that an unauthorized disclosure of his confidential health information did occur, appropriate disciplinary action had been taken and steps put into place to prevent such a breach from happening in the future.

What did the nurse tell Doe about the STD?

While Doe was waiting for his treatment, the nurse texted her sister-in-law and told her Doe was being treated for the STD. The manner in which she texted this information led the sister-in-law to believe the staff was making fun of his diagnosis and treatment. The sister-in-law immediately forwarded the messages to Doe.

Why is it so difficult to track the scope of trafficking?

It is difficult to track the scope of trafficking because of the underground or hidden nature of activities. Most victims in the U.S. are unwilling participants in the sex trade.

Is a medical facility responsible for safekeeping patient information?

The court opined that a medical facility’s duty of safekeeping a patient’s confidential medical information is “limited to those risks that are reasonably foreseeable and to actions within the scope of employment.”. Because the nurse’s misconduct did not meet these requirements, the facility cannot be held liable in this case or any other case in ...

Did Doe sue the nurse?

Apparently Doe did not name the nurse in his lawsuit but elected to sue only the facilities that either owned or provided staff and other support to the facility. Perhaps Doe thought this was how he could obtain the largest amount of a monetary award. If so, the decision was unwise at best.

How to enforce HIPAA?

HIPAA and patient confidentiality laws 1 Create privacy policies and procedures designed to help the business follow HIPAA standards. 2 Routinely monitor how well your organization follows patient confidentiality laws. 3 Have a HIPAA compliance officer who investigates any confidentiality complaints. 4 Train all employees on how to follow HIPAA standards during the course of their work. 5 Install safeguards on any device containing PHI so that only authorized individuals can access it. 6 Encrypt all PHI. 7 Sign a HIPAA business associate agreement with any third party that can access or use your data.

How to follow HIPAA standards?

Here are some basic ways you can follow HIPAA standards: Appoint a HIPAA compliance officer for your business. Create a privacy policy and HIPAA compliance procedures.

What is the HIPAA Act?

HIPAA is a federal law that regulates how people’s protected health information, or PHI, can be used and stored. Any business or agency that has access ...

How can employees violate HIPAA?

Employees can violate HIPAA by looking at patient records they don’t need to access for their job, posting patient information on social media, and not taking proper precautions to protect patient privacy. These breaches often happen because employees don’t understand that their actions violate HIPAA.

How long can you go to jail for HIPAA violations?

Criminal HIPAA violations can land you in jail for up to 10 years.

Why do employees have unsecure access to PHI?

These breaches often happen because employees don’t understand that their actions violate HIPAA. Unsecured access to PHI occurs for many reasons. The device storing the information might not be equipped with basic security measures, such as passwords and data encryption.

Can you get fined for HIPAA violations?

HIPAA violations that fall in the civil category usually incur fines instead of jail time. These fines can be lighter if you are unaware that something violates HIPAA, only violate HIPAA once, or try to correct the violation as soon as possible.

Hipaa Protects Patient Privacy

Patient Rights and Breaches of Confidentiality

  • According to HIPAA, medical professionals and other workers in healthcare and medical records are responsible for protecting and maintaining patient information, both to ensure that patients get continuity in coverage and care and also to protect patient privacy. Patients have certain rights under HIPAA, and it is important that they understand the...
See more on standardsofcare.org

When Hipaa Violations Are Malpractice

  • As with any type of medical malpractice, proving that it has occurred requires several steps. Regardless of the accusations made by the patient and their legal team, it must be proven that the person being accused had a duty to provide care to the patient. It must then be shown that there was a breach in that duty, in this case a breach in confidentiality, and that the breach led directly …
See more on standardsofcare.org

Consequences of Breaches in Confidentiality

  • Protecting individuals is an important reason to maintain privacy, but there is also a bigger picture. Maintaining confidentiality helps to establish trusting relationships between doctors and patients, and this is essential for patients to get the best care. If a patient does not trust medical professionals, he or she may not share all important information or take needed advice. Other c…
See more on standardsofcare.org

Examples of Privacy Lawsuits

  • The consequences of a breach in patient confidentiality can be very serious, often causing mental and emotional anguish more than physical harm. In one case a child suffered both as a result of a medical professional breaching his privacy. The eleven-year-old boy had attempted suicide and his mother sued the hospital where he received care, alleging that a staff member shared inform…
See more on standardsofcare.org